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Hazards of Illicit Methamphetamine Production and Efforts at Reduction: Data from the Hazardous Substances Emergency Events Surveillance System

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Hazards of Illicit Methamphetamine Production and Efforts at Reduction: Data from the Hazardous Substances Emergency Events Surveillance System Research Articles Hazards of Illicit Methamphetamine Production and Efforts at Reduction: Data from the Hazardous Substances Emergency Events Surveillance System Natalia Melnikova, MD, PhDa ABSTRACT Wanda Lizak Welles, PhDb Rebecca E. Wilburn, MPHb Objectives. Methamphetamine (meth) is a highly addictive drug of abuse that Nancy Rice, MPHc can easily be made in small illegal laboratories from household chemicals that Jennifer Wu, MSa are highly toxic and dangerous. Meth labs have been found in locations such Martha Stanbury, MSPHd as homes, outbuildings, motels, and cars. Its production endangers the “cook,” neighbors, responders, and the environment. This article describes surveil­ lance data used to examine the emergence and public health impacts of illicit clandestine meth labs, as well as two states’ efforts to thwart lab operations and prevent responder injuries. Methods. We analyzed data collected from 2001 to 2008 by 18 states partici­ pating in the Agency for Toxic Substances and Disease Registry’s Hazardous Substances Emergency Events Surveillance (HSEES) Program to examine the occurrence and public health impacts of clandestine meth production. Results. HSEES data indicate that the majority of clandestine meth lab events occurred in residential areas. About 15% of meth lab events required evacua­ tion. Nearly one-fourth of these events resulted in injuries, with 902 reported victims. Most victims (61%) were official responders, and one-third were members of the general public. Since 2004, with the implementation of local and federal laws and prevention activities, the number of meth lab events has declined. Increased education and training of first responders has led to decreased injuries among police officers, firefighters, and emergency medical personnel. Conclusions. HSEES data provided a good data source for monitoring the emergence of domestic clandestine meth production, the associated public health effects, and the results of state and federal efforts to promote actions to address the problem. aCenters for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, Division of Health Studies, Atlanta, GA bNew York State Department of Health, Center for Environmental Health, Division of Environmental Health Assessment, Bureau of Toxic Substance Assessment, National Toxic Substance Incidents Program, Troy, NY cMinnesota Department of Health, Environmental Health Division, Hazardous Substances Emergency Events Surveillance Program, St. Paul, MN dMichigan Department of Community Health, Division of Environmental Health, Lansing, MI Address correspondence to: Natalia Melnikova, MD, PhD, Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, Division of Health Studies, 4770 Buford Hwy., MS F-57, Atlanta, GA 30341; tel. 770-488-3697; fax 770-488-7187; e-mail <[email protected]>. 116 Public Health Reports / 2011 Supplement 1 / Volume 126 Meth Production Hazards and Reduction Efforts 117 Methamphetamine (meth) is a psychostimulant and METHODS sympathomimetic drug, with medical uses for the treat­ From 1990 to 2009, the Hazardous Substances Emer­ ment of narcolepsy, attention deficit disorders, and gency Events Surveillance (HSEES) Program, estab­ obesity. Long-term meth use has numerous adverse lished by the Centers for Disease Control and Preven­ physical and psychological consequences.1–3 Meth is tion and the Agency for Toxic Substances and Disease a very addictive drug with a high potential for abuse. Registry (ATSDR), collected and analyzed information According to the 2007 National Survey on Drug Use about acute releases of hazardous substances and and Health, approximately 13 million Americans aged threatened releases that resulted in a public health 12 years or older reported using meth at least once action, such as an evacuation. The goal of the program during their lifetime.4 was to use the collected data to identify prevention Unlike drugs such as marijuana or heroin, which strategies that could be implemented to reduce the are derived from plants, meth can be synthesized in frequency of these events and the associated morbid­ clandestine drug laboratories using a variety of easily ity (injury) and mortality (death) experienced by first bought chemicals that are “cooked” with ephedrine- or responders, employees, and the general public. The pseudoephedrine-containing products. The chemi­ ATSDR HSEES Program provided funding to a num­ cals vary depending on the process, but can include ber of state health departments to identify and record anhydrous ammonia, drain cleaners, paint thinner, information on spill/release events occurring in the metallic lithium, hydrochloric or sulfuric acids, starter funded states. An eligible HSEES event was defined fluid, camping fuel, and others. Chemicals found in by ATSDR protocol as any uncontrolled or illegal meth labs are hazardous and toxic. Exposure to the release or threatened release of one or more hazard­ chemicals or by-products can damage the respiratory ous substance(s) (excluding releases of petroleum) in tract, mucous membranes, eyes, and skin. It is relatively a quantity sufficient to require removal, cleanup, or easy for a cook to acquire the chemicals and recipes neutralization according to federal, state, or local law. necessary to make meth.5 Labs have been found in A clandestine drug lab incident was included in the fixed locations—homes, outbuildings, and hotel/ HSEES system if there was an acute release of a hazard­ motel rooms—or in mobile sites, such as trunks of cars, ous substance (i.e., the lab was in operation [“cooking”] motor homes, or moving vans. The processes used to within 72 hours of the lab seizure by law enforcement). make meth can result in fires, explosions, spills, or air Incidents without a known chemical release within the releases of hazardous chemicals, putting the cook and 72-hour period, but with a public health action, such others nearby, including children and responders, at as an evacuation, were also included. risk of injury or death.6–9 States participating in the HSEES Program identified To address the chemical and physical hazards associ­ events from a variety of sources, including state envi­ ated with illicit clandestine labs, federal and state gov­ ronmental conservation or protection agencies, police ernments have passed legislation aimed at decreasing and fire departments, poison control centers, federal the number of meth labs. In 2004, many states began databases (i.e., U.S. Coast Guard National Response applying strong restrictions on sales of ephedrine- and Center and U.S. Department of Transportation Haz­ pseudoephedrine-containing products, which are the ardous Material Information Resource System), hos­ key ingredients in meth production. In September pitals, local media, and others. Some states routinely 2006, the Federal Combat Methamphetamine Epi­ received reports from law enforcement on meth lab demic Act of 2005 restricted the retail sale of ephedrine seizures. Collected information was entered into a and pseudoephedrine products nationwide.10 However, standardized, secure Web-based system maintained illegal meth production and abuse continue to be seri­ by ATSDR. Information recorded included the event ous concerns within the United States and throughout location, the responsible party, the types and quantities the world.11 of chemical(s) involved, primary and secondary causes This article describes the public health impacts of of the release, the number of individuals injured as a clandestine meth production in 18 states that collected result of the release, the types of injuries, the number data on acute releases of hazardous substances. It also of people decontaminated, and the number of people provides information on the actions taken in two states evacuated or sheltered in place. to control illicit meth production and prevent injuries We analyzed retrospective data, 2001–2008 (the lat­ to first responders and bystanders during clandestine est complete year of data), from the HSEES system to lab seizures by law enforcement. identify trends in illegal clandestine meth lab events and in the public health consequences (e.g., morbidity, Public Health Reports / 2011 Supplement 1 / Volume 126 118 Research Articles mortality, and evacuations). The analysis included Table 1. All HSEES events and clandestine meth lab data collected by the 18 state health departments that events, by year: ATSDR HSEES database, 2001–2008 participated in the HSEES Program at any time from 2001 to 2008. Eleven states (Colorado, Iowa, Louisi­ HSEES events Meth events Meth events Year N N Percent ana, Minnesota, New York, North Carolina, Oregon, Texas, Utah, Washington, and Wisconsin) collected 2001 8,978 297 3.3 information during the entire period. Seven states 2002 9,014 423 4.7 participated at various times during the period (New 2003 9,105 524 5.8 2004 7,744 442 5.7 Jersey: 2001–2008, excluding 2006; Alabama and Mis­ 2005 8,603 300 3.5 sissippi: 2001–2003; Florida and Michigan: 2005–2008; 2006 7,267 180 2.5 Missouri: 2001–2005; and Rhode Island: 2001). 2007 7,947 102 1.3 2008 7,930 105 1.3 Total 66,588 2,373 3.6 RESULTS HSEES 5 Hazardous Substances Emergency Events Surveillance Overall, 3.6% (n52,373) of the total HSEES events ATSDR 5 Agency for Toxic Substances and Disease Registry (n566,588) reported from 2001 to 2008 were meth meth 5 methamphetamine related (Table 1). The highest percentage of meth lab events were reported in 2003 (n5524 events, 5.8% labs in cars
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